Since mother’s pharmacy was located in a Wal-Mart, I left the scripts with capable pharmacists and shopped awhile. Returning to pick up her medicines the pharmacist called me to come over and discuss the different medications and their uses and required knowledge. Then he paused and said,

Now, I need to tell you that your mother’s pain medication will have to be purchased by you, as Medicare will not pay for these, as your mother is too old.

Thinking I heard the man wrong, I asked him,

Did I hear you correctly? Did I hear you say my mother is too old for pain medication following surgery?

The druggist, smiling, repeated his previous comment, reiterating that Medicare, at least in his district, refuses to pay for pain medication for seniors, even following surgery.

That’s just one anecdotal story, of course. I’m sure someone supportive of government run health care would argue that she misunderstood, or that the pharmacist misunderstood, or that the pharmacist was a sadist, or that it was only specific types of medicine and not just any medicine, and so on and so forth.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.

“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.

The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.

The article describes the humanitarian motives behind that LCP. I’m willing to believe that. The problem is that the government doesn’t have humanitarian motives. It has guidelines. And as well all know, humans don’t fit into guidelines. Indeed, the human unwillingness to fit into tight little packages ties into another problem with guidelines: they are inflexible. Humans are not. Another thing that’s fairly flexible is the marketplace. If too many people complain about watching Mom or Dad starve and dehydrate to death, the market adapts. The government doesn’t.

Why in the world would Americans want to go even further down this path than they already have?

Two weeks ago, I received from Medicare a notice stating that they would no longer pay for XXXX. It’s OTC so I was not too concerned, but concerned enough that I mentioned it to the nursing staff where my mother lives.

Without flinching and without me mentioning what the item was … several of them in unison said, oh sure, we’ve had several family members here, who have received ‘deleted’ from the list notices.